| NPI | 1073151684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MS 903693) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MS 903693) |
| Enumeration Date | 2019-12-13 |
| Last Update Date | 2019-12-13 |