| NPI | 1134502792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R883041) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09540) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2023-03-07 |