| NPI | 1649642349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018036142) |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: MO 2011009680) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2018-11-05 |