NPI | 1699309120 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 79321) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 79321) |
363L00000X Nurse Practitioner (Licence: KS 53-79321) | |
Enumeration Date | 2020-02-24 |
Last Update Date | 2024-09-13 |