| NPI | 1295240414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902443) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23699) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2022-01-27 |