NPI | 1033574116 |
---|---|
Former Name | MICHELLE MOMOE SOGA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: HI APRN 2025) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: HI APRN-2025) |
Enumeration Date | 2015-12-16 |
Last Update Date | 2022-03-29 |