| NPI | 1508317157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2023038573) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023038573) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-10-11 |