| NPI | 1215437058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902513) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS MCCO-RFN3U1) |
| 207Q00000X Family Medicine (Licence: MS F01180598) | |
| 363L00000X Nurse Practitioner (Licence: MS 902513) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS 902513) | |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2022-09-03 |