| NPI | 1124563275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016043696) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A153239) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2019-02-01 |