| NPI | 1700422490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP001684) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2021-06-07 |