| NPI | 1073992384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015003182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2015003182) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2015003182) | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2016-04-05 |