| NPI | 1740587344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2010042075) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004018917) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2011-02-16 |