| NPI | 1891552758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024008620) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82966-101) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-12-13 |