| NPI | 1962247429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2024028413) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2017023953) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-08-29 |