| NPI | 1649515917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2012036776) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 133V00000X Dietitian, Registered (Licence: MO 2001025004) | |
| Enumeration Date | 2012-11-28 |
| Last Update Date | 2021-01-15 |