| NPI | 1376397331 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004876)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82989-041)  | 
| Enumeration Date | 2024-04-16 | 
| Last Update Date | 2024-04-16 |