| NPI | 1013465830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016034594) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2008036006) |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2016-09-27 |