| NPI | 1568727352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 880108) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS R880108) |
| 363L00000X Nurse Practitioner (Licence: MS R880108) | |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2021-07-08 |