| NPI | 1003379629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F01191298) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-06-13 |