| NPI | 1770242794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021041804) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR 217844) |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2021-12-17 |