| NPI | 1649751462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018031883) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2002006436) |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-09-05 |