| NPI | 1003674995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024006641) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84454-121) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2026-05-15 |