NPI | 1629745591 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021035531) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80473-071) |
Enumeration Date | 2021-08-27 |
Last Update Date | 2025-01-17 |