| NPI | 1043747504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO F06162109) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007021109) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2023-01-05 |