| NPI | 1275071854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017001316) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010022894) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |