| NPI | 1912302159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MS 905597) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AL 1-099664) |
| 163W00000X Registered Nurse (Licence: MS R866997) | |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2024-03-14 |