NPI | 1043660392 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2011018481) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 14-120808-092) |
Enumeration Date | 2016-06-17 |
Last Update Date | 2017-11-09 |