| NPI | 1295220374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2018020753) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2018020753) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2023-02-21 |