NPI | 1184979098 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012041039) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75820-112) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2025-05-07 |