| NPI | 1003370081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020024185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5379641) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2021-02-17 |