| NPI | 1205355765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS R902312) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 902312) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2023-01-04 |