NPI | 1417464926 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017035515) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77965-092) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2017035515) | |
Enumeration Date | 2018-01-05 |
Last Update Date | 2022-01-20 |