NPI | 1124586086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-137652) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 903475) |
Enumeration Date | 2019-03-08 |
Last Update Date | 2023-12-12 |