NPI | 1255895496 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2019000944) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2019000944) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2023-08-09 |