| NPI | 1235553462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 813152) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MS R813152) |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2020-01-17 |