NPI | 1144640293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201602750NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 5720) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95002389) | |
Enumeration Date | 2014-04-16 |
Last Update Date | 2018-01-02 |