| NPI | 1740750769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 20180445165) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78554) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2024-01-02 |