| NPI | 1649524612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 63085) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 235304) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2022-11-16 |