NPI | 1679809719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 75029) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014029940) |
Enumeration Date | 2009-10-25 |
Last Update Date | 2021-09-11 |