| NPI | 1649044397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023044955) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82630-122) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |