NPI | 1740517515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2009034346) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004018016) |
Enumeration Date | 2009-11-15 |
Last Update Date | 2021-03-29 |