| NPI | 1659635316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 20121137) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2006027479) |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2012-06-27 |