| NPI | 1639803430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 905438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 227103) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 227103) | |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2023-05-04 |