| NPI | 1124319439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011009687) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011009867) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2022-12-29 |