| NPI | 1275348153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 12604) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS TMP-162792) |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-10-30 |