| NPI | 1538740261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021018304) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015035769) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-08-03 |