| NPI | 1952408262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016019093) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 144607) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 2016019093) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-03-25 |