| NPI | 1023323078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 872496)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R872496)  | 
| Enumeration Date | 2010-08-15 | 
| Last Update Date | 2022-08-15 |