NPI | 1366923278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2019009624) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 53-78268) |
Enumeration Date | 2018-08-28 |
Last Update Date | 2019-06-07 |