| NPI | 1750118881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024033979)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5383623)  | 
| Enumeration Date | 2024-09-13 | 
| Last Update Date | 2024-09-23 |