NPI | 1376397331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024004876) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82989-041) |
Enumeration Date | 2024-04-16 |
Last Update Date | 2024-04-16 |