| NPI | 1376269472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022041568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS TMP-161142) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2023-04-26 |