| NPI | 1164155297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 905405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905405) |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2024-08-15 |