NPI | 1114502895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11011743) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 9254093) |
Enumeration Date | 2021-03-14 |
Last Update Date | 2021-03-14 |