| NPI | 1134739626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903989) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179477) |
| Enumeration Date | 2020-08-09 |
| Last Update Date | 2022-09-16 |