NPI | 1083127013 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018093) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA SP018093) |
Enumeration Date | 2017-11-13 |
Last Update Date | 2024-09-04 |