| NPI | 1053618355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 877154) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R877154) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2020-08-11 |