| NPI | 1790395150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5379490042) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11008165) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020017322) | |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2021-03-12 |