| NPI | 1942694260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902272) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19764) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-04-20 |