| NPI | 1265900450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018011508) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013025839) |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2020-10-27 |