| NPI | 1326565763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 90228) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MS 902228) |
| 363L00000X Nurse Practitioner (Licence: MS 902228) | |
| Enumeration Date | 2017-08-25 |
| Last Update Date | 2020-07-28 |