| NPI | 1891340584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 20190105340) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-78693-091) |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2023-08-01 |