| NPI | 1962950303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901636) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R901636) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2022-07-21 |