NPI | 1447894829 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020001360) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2016000739) |
363LF0000X Nurse Practitioner, Family (Licence: KS 53-79286-111) | |
Enumeration Date | 2019-10-29 |
Last Update Date | 2020-05-27 |