| NPI | 1417725391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82611-081) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1142373) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-10-08 |