| NPI | 1184262941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020021045) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79143-092) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 79143) | |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2024-02-27 |