NPI | 1245747005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2017042704) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-77990-072) |
363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2017042704) | |
363LG0600X Nurse Practitioner, Gerontology (Licence: KS 53-77990-072) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2017042704) | |
Enumeration Date | 2018-01-02 |
Last Update Date | 2024-07-25 |