| NPI | 1962832980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2013039397) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2008020336) |
| Enumeration Date | 2013-11-13 |
| Last Update Date | 2024-01-29 |