| NPI | 1942891007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2021003903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO F01210949) |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2021-09-28 |