NPI | 1336634294 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78322) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019000929) |
Enumeration Date | 2018-06-24 |
Last Update Date | 2024-08-01 |