| NPI | 1699372169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904078) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MS 904078) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 216015) | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2022-05-17 |