NPI | 1417571399 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-79551-101) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 124319) |
Enumeration Date | 2020-06-05 |
Last Update Date | 2020-12-03 |