| NPI | 1407804867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 104163) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO RN104163) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2019-01-02 |