NPI | 1265283923 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004868) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2020001218) |
363LF0000X Nurse Practitioner, Family (Licence: KS 5383440042) | |
Enumeration Date | 2024-04-01 |
Last Update Date | 2025-10-06 |