| NPI | 1336764778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904716) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27403) |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2021-11-08 |