NPI | 1164635637 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MO 2017028577) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: KS 44460) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2024-08-02 |