| NPI | 1740918341 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022029741)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS F02221106)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: KS 5380894)  | |
| Enumeration Date | 2022-08-11 | 
| Last Update Date | 2022-09-02 |