| NPI | 1902338254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017004853) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77557-101) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-07-01 |