| NPI | 1811450067 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ 261898) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-99875-091) |
| 163W00000X Registered Nurse (Licence: MO 2006019378) | |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2019019648) | |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-07-17 |