NPI | 1134883614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021046260) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2004018496) |
163W00000X Registered Nurse (Licence: KS 14-113338-032) | |
Enumeration Date | 2021-10-29 |
Last Update Date | 2021-12-21 |