NPI | 1164177580 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP024090) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN701520) |
Enumeration Date | 2022-02-14 |
Last Update Date | 2022-02-14 |