| NPI | 1649778960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184530) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78035-041) |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2022-10-21 |