| NPI | 1922967991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2025042803) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019009056) |
| 363L00000X Nurse Practitioner (Licence: KS 53-84890-081) | |
| Enumeration Date | 2026-01-16 |
| Last Update Date | 2026-01-16 |