| NPI | 1750978300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020039165) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 14-147909-071) |
| Enumeration Date | 2020-12-30 |
| Last Update Date | 2020-12-30 |