| NPI | 1265754147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2009034995) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2009034995) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2020-10-28 |