NPI | 1154861276 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R0134145) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017002508) |
Enumeration Date | 2017-03-08 |
Last Update Date | 2019-10-16 |