| NPI | 1720386659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: MO 2011004377) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2011004377) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2018-11-06 |