| NPI | 1780397265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022045900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81714-101) |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2024-11-11 |