| NPI | 1386032811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022020580)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82018-041)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: AR A004262)  | |
| Enumeration Date | 2015-01-06 | 
| Last Update Date | 2023-07-05 |