| NPI | 1972158392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020010820) |
| Additional Taxonomies | 163WN0800X Registered Nurse, Neuroscience (Licence: MO 2016001784) |
| 363L00000X Nurse Practitioner (Licence: KS 5379431072) | |
| Enumeration Date | 2019-08-02 |
| Last Update Date | 2021-08-17 |