| NPI | 1104368406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 0000019622) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905037) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2022-09-01 |