NPI | 1457878241 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024008616) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79561-042) |
Enumeration Date | 2017-08-23 |
Last Update Date | 2024-06-10 |