| NPI | 1679977623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO F1014273) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014038753) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2020-01-23 |