NPI | 1134614050 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC AG06180130) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010732) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5010732) | |
Enumeration Date | 2018-06-23 |
Last Update Date | 2020-03-20 |