| NPI | 1508260696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015002036) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010007952) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2023-01-31 |