| NPI | 1124490107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015037598) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015037598) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2024-01-18 |