NPI | 1902372055 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KS 53-78375-022) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018031416) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2024-01-04 |