NPI | 1013209188 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011009484) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 5375392021) |
363L00000X Nurse Practitioner (Licence: MO 2011009484) | |
Enumeration Date | 2011-05-09 |
Last Update Date | 2023-07-08 |