NPI | 1255757969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014004538) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-76308-052) |
Enumeration Date | 2014-03-06 |
Last Update Date | 2023-05-23 |