| NPI | 1265102420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021042422) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014021376) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2021-10-19 |