| NPI | 1558918540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904865) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 879505) |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2022-03-02 |