| NPI | 1497281166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016030305) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 8689) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A150895) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2022-02-23 |