| NPI | 1235653445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903323) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 22821) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22821) | |
| Enumeration Date | 2017-07-29 |
| Last Update Date | 2023-03-07 |