| NPI | 1518571900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MS 901770) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 901770) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2022-11-10 |