| NPI | 1962960708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018034004) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78508-112) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2021-09-22 |