NPI | 1255096673 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80439-041) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021029770) |
Enumeration Date | 2021-11-01 |
Last Update Date | 2022-03-21 |