| NPI | 1154066264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2023019709) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020015824) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2024-01-09 |