NPI | 1124018437 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 105599) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 75874) |
363LP2300X Nurse Practitioner, Primary Care (Licence: KS 74692) | |
Enumeration Date | 2005-10-27 |
Last Update Date | 2021-11-29 |