| NPI | 1407218712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2018024577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014004384) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2018-12-04 |