| NPI | 1104470772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019043201) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: MO 135267) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2019043201) | |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2021-10-25 |