NPI | 1376732925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2003018837) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 14-97699-042) |
Enumeration Date | 2007-10-19 |
Last Update Date | 2021-02-22 |