NPI | 1225646417 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79531-011) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2016026783) |
Enumeration Date | 2020-07-14 |
Last Update Date | 2020-07-14 |