NPI | 1720579808 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017040108) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MO 124618) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2017040108) | |
Enumeration Date | 2018-05-23 |
Last Update Date | 2018-08-08 |