| NPI | 1215525399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904355) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: MS 891948) |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-02-03 |