| NPI | 1740481142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2000163259) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 200163259) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2021-03-29 |