| NPI | 1376055004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 20180009355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013031244) |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2022-07-21 |