NPI | 1710655436 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2021006049) |
Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: KS 53-80033-111) |
Enumeration Date | 2021-08-30 |
Last Update Date | 2024-01-15 |