| NPI | 1003567215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2022000769) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IL 209028348) |
| 363LF0000X Nurse Practitioner Family (Licence: KS 53-80842-052) | |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2023-10-03 |