| NPI | 1629302823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 871899) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS R871899) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2020-04-14 |