| NPI | 1043568280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012021023) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 125820) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |