| NPI | 1114339470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014004541) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009019269) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-06-27 |