| NPI | 1508412446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019042204) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79103-041) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2022-10-21 |