NPI | 1164007746 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1036693) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: OH AG0820083) |
Enumeration Date | 2021-03-15 |
Last Update Date | 2022-08-24 |