| NPI | 1164951117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017019298) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013006252) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2019-05-09 |