| NPI | 1053919118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2020034593) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2014039582) |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2020-10-22 |