| NPI | 1962170845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 80517) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 147090) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2023-09-08 |