| NPI | 1952968141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019018507) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019013311) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-07-03 |