NPI | 1114448040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 7796-33) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 164390-30) |
Enumeration Date | 2017-06-30 |
Last Update Date | 2020-07-07 |