| NPI | 1609684398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024046878) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2022001610) |
| 163W00000X Registered Nurse (Licence: PA RN637529) | |
| Enumeration Date | 2024-12-26 |
| Last Update Date | 2024-12-26 |