| NPI | 1124691191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904301) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 901425) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |