| NPI | 1467114801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2021044923) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2021044923) |
| 163W00000X Registered Nurse (Licence: MO 2014004469) | |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2022-04-12 |