| NPI | 1780346569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021040982) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2021040982) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82799-091) | |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2025-01-10 |