| NPI | 1053630806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 814869) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R814869) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2024-08-22 |