| NPI | 1821565235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS R902616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN APN24782) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2019-11-04 |