| NPI | 1558812263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS F0815355) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 881624) |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2019-04-14 |