| NPI | 1770193161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020016732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79528-072) |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2021-02-17 |