| NPI | 1942627237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MO 2014010577) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 106702) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2019-01-21 |