| NPI | 1083250179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MS 898230) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 904314) |
| Enumeration Date | 2019-11-23 |
| Last Update Date | 2022-03-30 |