| NPI | 1811293756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011006223) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2002003047) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2021-03-04 |