| NPI | 1336683812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016041524) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 133017) |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2016-12-18 |