| NPI | 1700123361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025033712) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79513-092) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2025-10-28 |