| NPI | 1235548363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902207) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18863) | 
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02586) | |
| Enumeration Date | 2014-08-02 | 
| Last Update Date | 2022-07-21 |