| NPI | 1679843544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 876329) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R876329) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2024-10-10 |