NPI | 1154789048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2015040102) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015040102) |
Enumeration Date | 2016-02-05 |
Last Update Date | 2024-08-16 |