NPI | 1659958502 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-80152-032) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021011107) |
Enumeration Date | 2021-03-26 |
Last Update Date | 2024-02-20 |