| NPI | 1427605161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-120774) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 208338) | |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2020-05-02 |