| NPI | 1710655436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2021006049) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KS 53-80033-111) |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2024-01-15 |