NPI | 1124454905 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-100814) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 38697) |
Enumeration Date | 2013-09-24 |
Last Update Date | 2022-02-24 |