| NPI | 1649636549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 77072) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 98547) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2025-07-15 |