NPI | 1578170692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-79640-121) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2020029662) |
Enumeration Date | 2020-09-24 |
Last Update Date | 2024-11-20 |