NPI | 1154957215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 239604) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 13742545-4405) |
363LF0000X Nurse Practitioner, Family (Licence: OR 202011282NP-PP) | |
Enumeration Date | 2020-03-19 |
Last Update Date | 2024-02-19 |