NPI | 1376308486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KS 82904) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-82904-091) |
363LF0000X Nurse Practitioner, Family (Licence: KS 53-82904-091) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-82904-091) | |
Enumeration Date | 2024-02-19 |
Last Update Date | 2025-03-26 |