| NPI | 1407466568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022015838) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5308091081) |
| Enumeration Date | 2020-08-04 |
| Last Update Date | 2022-07-08 |