| NPI | 1922750546 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-80921-042) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 00000000000) |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-04-07 |