| NPI | 1588134332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 24260) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 2289897) |
| 363L00000X Nurse Practitioner (Licence: MA RN2289897) | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2021-01-18 |