NPI | 1457551905 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 46056) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-46056-081) |
363LF0000X Nurse Practitioner, Family (Licence: KS 54-46056-081) | |
Enumeration Date | 2007-07-23 |
Last Update Date | 2022-06-03 |