| NPI | 1295253359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017032044) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 22551-875) |
| 363L00000X Nurse Practitioner (Licence: WI 13648-33) | |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2023-03-17 |