| NPI | 1164054656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019046171) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F07190166) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-12-02 |