| NPI | 1407417645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2021013574) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2321686) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-03-21 |