| NPI | 1609246552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015037187) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO F09151382) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2017-04-05 |