| NPI | 1760825988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KS 75950) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2016044694) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2024-03-04 |