NPI | 1053681049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75524) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 78516) |
Enumeration Date | 2012-01-06 |
Last Update Date | 2015-10-01 |