| NPI | 1851021893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022018279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79877-042) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |