| NPI | 1295446706 |
|---|---|
| Former Name | TERESA LYNNE VITITOE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2022042404) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2022042404) |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2024-05-21 |