NPI | 1013405711 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-215158) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 0993867) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-215158) | |
363LF0000X Nurse Practitioner, Family (Licence: CO 0993867) | |
Enumeration Date | 2018-04-27 |
Last Update Date | 2023-09-26 |