| NPI | 1982364394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2022000243) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2022000243) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MO AG12210107) | |
| Enumeration Date | 2021-12-27 |
| Last Update Date | 2023-03-01 |