| NPI | 1609341908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903943) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP019383) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2020-06-29 |