| NPI | 1942889563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2021013057) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KS 53-80039-012) |
| Enumeration Date | 2021-04-02 |
| Last Update Date | 2022-02-16 |