NPI | 1124255658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007173) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 054912-23) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NH 054912-23) | |
Enumeration Date | 2009-06-11 |
Last Update Date | 2023-02-15 |