NPI | 1124595467 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R192282) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DC RN1046170) |
Enumeration Date | 2018-10-24 |
Last Update Date | 2024-01-15 |