NPI | 1740583897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010031309) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75284-122) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11018451) | |
Enumeration Date | 2010-12-13 |
Last Update Date | 2022-08-17 |