| NPI | 1780884916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 1999136138) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R878465) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2018-08-01 |