NPI | 1134739626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903989) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179477) |
363LF0000X Nurse Practitioner, Family (Licence: OH 921059) | |
Enumeration Date | 2020-08-09 |
Last Update Date | 2024-12-02 |