| NPI | 1265979256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 2011003665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011003665) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |