| NPI | 1356073712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2022024062) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2022024062) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2022024062) | |
| Enumeration Date | 2022-06-25 |
| Last Update Date | 2024-09-10 |