NPI | 1508201963 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 5375975081) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013006422) |
Enumeration Date | 2013-04-29 |
Last Update Date | 2024-04-20 |