NPI | 1720511462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-77364-111) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017010119) |
Enumeration Date | 2017-04-10 |
Last Update Date | 2018-03-17 |