| NPI | 1366190787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2022015782) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013024260) |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2022-12-12 |