| NPI | 1780001024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76325-011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704378720) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-06-05 |