NPI | 1154612307 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011010122) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375379091) |
Enumeration Date | 2011-04-22 |
Last Update Date | 2023-06-22 |