| NPI | 1740030816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024012230) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5383092) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-04-26 |