| NPI | 1962196857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022026875) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-84180-011) |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2025-06-26 |