| NPI | 1861918120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017038734) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2007029427) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2018-01-22 |