| NPI | 1164130779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022025650) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022025650) |
| Enumeration Date | 2022-11-11 |
| Last Update Date | 2022-11-19 |