| NPI | 1326793480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022024659) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80924-051) |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-09-13 |