| NPI | 1861887689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2015007597) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013032134) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |