NPI | 1306658570 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025003389) |
Additional Taxonomies | 163WC1600X Registered Nurse, Continuing Education/Staff Development (Licence: MO 2018025751) |
363L00000X Nurse Practitioner (Licence: MO 2025003389) | |
Enumeration Date | 2025-01-23 |
Last Update Date | 2025-09-18 |