NPI | 1295120533 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021039036) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 14-130993-112) |
Enumeration Date | 2015-04-03 |
Last Update Date | 2021-11-22 |