NPI | 1164209862 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 77117) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NM RN-89669) |
Enumeration Date | 2023-09-14 |
Last Update Date | 2023-12-19 |