NPI | 1962794586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011010360) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75274) |
Enumeration Date | 2011-05-16 |
Last Update Date | 2016-12-07 |