| NPI | 1720863665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906228) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 865829) |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2024-06-28 |