| NPI | 1487195251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015042859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015042859) |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2021-06-10 |