NPI | 1043722523 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60785562) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201709200NP-PP) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP134411) | |
Enumeration Date | 2017-10-24 |
Last Update Date | 2021-08-28 |