| NPI | 1699156372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015006323) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 11015-33) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2015006323) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2023-03-20 |