| NPI | 1659902583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020002810) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2020002810) |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2024-07-23 |