| NPI | 1538717871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019035915) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2012042941) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2019035915) | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2023-11-20 |