NPI | 1003240359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11013672) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO NP 0990840) |
363LF0000X Nurse Practitioner, Family (Licence: NH 074932-23) | |
Enumeration Date | 2013-08-22 |
Last Update Date | 2022-10-13 |