| NPI | 1154869220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016044349) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2016044349) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2022-09-06 |