NPI | 1124620893 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2020041026) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: WI 226456-30) |
Enumeration Date | 2020-11-09 |
Last Update Date | 2021-03-01 |