| NPI | 1740794601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902418) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24038) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2024-04-09 |