| NPI | 1083217038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 315528) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79642-102) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020037161) | |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2025-10-08 |