| NPI | 1235695768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25843) |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2022-12-29 |