| NPI | 1598122491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2016001997) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2000163273) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |