| NPI | 1669922068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2016036661) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2010003376) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2016-10-12 |