| NPI | 1164116398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023039397) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 4005313) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2023-12-06 |