| NPI | 1003167735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012034634) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 148478) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012034634) | |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-10-31 |