| NPI | 1114564077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 903442) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003178) |
| Enumeration Date | 2019-12-10 |
| Last Update Date | 2022-11-28 |