| NPI | 1194273649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO F09170142) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2001021269) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2018-04-03 |