| NPI | 1083386643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R879104) |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2023-05-17 |