| NPI | 1356685648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014031135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2008006150) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2015-01-13 |