| NPI | 1932644465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO F1115467) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2015044721) |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2016-12-19 |