NPI | 1104367622 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R209451) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DC RN1032855) |
Enumeration Date | 2017-03-16 |
Last Update Date | 2024-01-11 |