| NPI | 1891249009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023021237) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: MO 2016027657) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2024-07-02 |