| NPI | 1720695190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903881) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS F02200321) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-09-29 |