| NPI | 1508359043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018029917) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009005945) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2018-08-14 |