| NPI | 1710421490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901630) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 859495) |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2017-03-13 |