NPI | 1063031730 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 9009) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 153082) |
Enumeration Date | 2020-04-13 |
Last Update Date | 2022-12-14 |