| NPI | 1619514437 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906454) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 23524) |
| Enumeration Date | 2019-12-01 |
| Last Update Date | 2024-03-12 |