| NPI | 1619668845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023024822) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 53-82196-062) |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2024-05-23 |