| NPI | 1073286696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2021025327) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2021025327) |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2023-02-02 |