| NPI | 1750412052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2002105397) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO RN2002015397) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-09-05 |