| NPI | 1720439029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902264) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902264) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024173682) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2020-07-29 |