| NPI | 1164867040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2013011245) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2013011245) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2025-02-11 |