| NPI | 1043551807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013000128) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2006021094) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |