| NPI | 1518583129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903762) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27393) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2022-04-19 |