| NPI | 1205482775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019040280) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-81827-091) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2026-04-22 |