| NPI | 1356959944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2020003607) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009019364) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2020003607) | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2021-05-25 |