NPI | 1083123780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 26378) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 217473) |
363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00778100) | |
Enumeration Date | 2017-09-25 |
Last Update Date | 2023-12-28 |