| NPI | 1912602004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 905633) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905633) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2024-04-01 |