| NPI | 1679577555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 895684) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19930) |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2023-07-26 |