| NPI | 1396391827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019028279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 2019028279) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2021-08-04 |