| NPI | 1215753397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024047258) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-162518) |
| Enumeration Date | 2024-11-23 |
| Last Update Date | 2024-12-04 |