| NPI | 1184091431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2018001284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2002031108) |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2022-05-11 |