| NPI | 1902465040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903214) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 25457) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2021-12-15 |