| NPI | 1144874769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019038966) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2002018650) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-08-09 |