| NPI | 1730650680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 118026) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2024042777) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2026-01-14 |