| NPI | 1770877623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R878053) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A004567) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 878053) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 18780) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2025-01-11 |