| NPI | 1841810991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 53-79360-022) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2013034067) |
| 363L00000X Nurse Practitioner (Licence: WA AP61091030) | |
| Enumeration Date | 2020-04-19 |
| Last Update Date | 2021-09-27 |