| NPI | 1962156190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 2023192642) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905144) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 905144) | |
| Enumeration Date | 2022-02-07 |
| Last Update Date | 2024-04-06 |