| NPI | 1255715058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015023451) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2015023451) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2018-03-22 |