| NPI | 1679919062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013002281) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2008021543) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2015-11-06 |