| NPI | 1336780493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: MO 2020004727) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015035802) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2020-02-09 |