| NPI | 1417427584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018025395) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011024822) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2018025395) | |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2022-09-16 |