| NPI | 1154104859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024001831) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2002019911) |
| Enumeration Date | 2023-08-16 |
| Last Update Date | 2024-01-18 |