| NPI | 1881575074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025038279) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-84768-052) |
| Enumeration Date | 2025-09-12 |
| Last Update Date | 2025-10-20 |