NPI | 1194194613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 76914) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-112404-121) |
163W00000X Registered Nurse (Licence: MO 2010018774) | |
Enumeration Date | 2015-09-15 |
Last Update Date | 2015-09-15 |