| NPI | 1003670258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83426-041) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11031542) | |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-08-23 |