| NPI | 1316429434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 902883) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS F09180077) |
| 363LF0000X Nurse Practitioner Family (Licence: MS F09180077) | |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2018-09-19 |