| NPI | 1194295642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2018043588) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2006023824) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2019-05-14 |