| NPI | 1740694074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2014018618) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014018618) |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2018-10-30 |