| NPI | 1336795616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO F10191170) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2008003894) |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2020-04-23 |