| NPI | 1508406802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 903635) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner Community Health (Licence: MS 903635) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-01-19 |