| NPI | 1336513894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015032923) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5376999022) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2024-02-05 |