| NPI | 1063156834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022004709) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 13-136073-011) |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-06-21 |