| NPI | 1952688178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011040127) |
| Additional Taxonomies | 163WP2201X Registered Nurse Ambulatory Care (Licence: MO 2007007648) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 2011040127) | |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2024-09-03 |