| NPI | 1780357202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2024005947) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-83004-012) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-03-22 |