NPI | 1053969014 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11032788) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL MO9002990) |
363LF0000X Nurse Practitioner, Family (Licence: CO APN.0994708-NP) | |
Enumeration Date | 2019-09-03 |
Last Update Date | 2024-08-16 |