| NPI | 1053884783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP70239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 5378522012) |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2024-04-15 |