| NPI | 1013581917 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020010568) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5382433) | 
| Enumeration Date | 2021-05-14 | 
| Last Update Date | 2023-11-29 |