| NPI | 1275936163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 810641) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19364) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2022-06-29 |