NPI | 1053865576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 207366) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20330) |
Enumeration Date | 2016-08-12 |
Last Update Date | 2021-11-03 |