| NPI | 1144835745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79614) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020029315) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2024-01-31 |