| NPI | 1629684865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020027480) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020027480) |
| Enumeration Date | 2020-09-22 |
| Last Update Date | 2024-06-12 |