| NPI | 1699157081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017015824) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R853023) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2022-09-12 |