| NPI | 1801397203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5377976062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017042568) |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2021-12-14 |