NPI | 1043210057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2347) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP30006889) |
Enumeration Date | 2005-08-01 |
Last Update Date | 2021-03-03 |