| NPI | 1700361755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022014047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 53-78334-102) |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2022-07-06 |