| NPI | 1972530632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R864863) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MS R864863) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS F0715496) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-01-31 |