NPI | 1043718760 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5380077) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018002991) |
Enumeration Date | 2018-01-28 |
Last Update Date | 2021-03-26 |