NPI | 1003303165 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202213854NP-PP) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A134262) |
Enumeration Date | 2018-04-15 |
Last Update Date | 2023-01-19 |