| NPI | 1295190130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2015034733) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012020476) |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2021-08-17 |