| NPI | 1649974486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5381971041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023010663) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2023-09-28 |