| NPI | 1710677992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2023015922) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023015922) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2023-10-17 |