| NPI | 1942193792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MO 2025013574) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2025013574) |
| 363LG0600X Nurse Practitioner Gerontology (Licence: MO 2025013574) | |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |