| NPI | 1235513953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO F0615663) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015025675) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2017-04-09 |