| NPI | 1225108558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018024090) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 201022760) |
| 101YM0800X Counselor, Mental Health (Licence: MO SW006050) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2018-08-29 |