NPI | 1629602024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82452-092) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020006521) |
Enumeration Date | 2020-02-25 |
Last Update Date | 2025-04-04 |