| NPI | 1255707907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016023910) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001746) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016023910) | |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2024-04-16 |