NPI | 1336648377 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019037892) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-78041-081) |
Enumeration Date | 2018-02-05 |
Last Update Date | 2024-04-30 |