NPI | 1710289426 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75256-112) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2011001351) |
Enumeration Date | 2010-12-01 |
Last Update Date | 2015-03-19 |