| NPI | 1902322787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 902236) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 902236) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 902236) | |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2019-03-14 |