NPI | 1003392036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-100479) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-100479) |
Enumeration Date | 2018-07-12 |
Last Update Date | 2021-08-18 |