| NPI | 1720400252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2014005150) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011012660) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2020-11-25 |