| NPI | 1871259499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021044721) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-80712-062) |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2022-01-26 |