| NPI | 1649225996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MO 064168) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 064168 Mo) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 064168) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-04-28 |