| NPI | 1114508298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021013570) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80328) |
| Enumeration Date | 2021-04-19 |
| Last Update Date | 2024-05-09 |