NPI | 1124363866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10018626) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 772869) |
Enumeration Date | 2012-12-06 |
Last Update Date | 2024-01-31 |