| NPI | 1790384329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904149) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27722) |
| Enumeration Date | 2020-10-24 |
| Last Update Date | 2020-10-24 |