| NPI | 1568452324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 43071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 143071) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2021-11-26 |