| NPI | 1912402785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78157) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018007349) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2020-11-30 |