| NPI | 1417537275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021040986) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2018007906) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-11-12 |