| NPI | 1013261619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 810549) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 17166) |
| 363L00000X Nurse Practitioner (Licence: MS A810549) | |
| Enumeration Date | 2012-11-04 |
| Last Update Date | 2022-02-02 |