| NPI | 1013561687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019040426) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015032860) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-03-24 |