| NPI | 1205483559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019026379) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78836-041) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-04-30 |