| NPI | 1124688858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019024652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012003128) |
| Enumeration Date | 2019-06-14 |
| Last Update Date | 2022-06-29 |