NPI | 1265095939 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78681) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019009623) |
Enumeration Date | 2019-04-18 |
Last Update Date | 2024-05-01 |