| NPI | 1891363636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021020871) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-81385-082) |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2024-02-15 |