| NPI | 1902323611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 902270) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 23022) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-11-30 |