NPI | 1023651080 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95023096) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN248182) |
363LF0000X Nurse Practitioner, Family (Licence: NY F351574-01) | |
363LF0000X Nurse Practitioner, Family (Licence: TX 1176917) | |
Enumeration Date | 2019-10-23 |
Last Update Date | 2024-12-18 |