| NPI | 1720796717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022021638) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81429-071) |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2025-07-15 |