| NPI | 1104223551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015012515) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76658-081) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2024-04-17 |