| NPI | 1568816221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901488) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 901488) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2017-05-10 |