NPI | 1164734117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD r243137) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC AP 19129) |
163W00000X Registered Nurse (Licence: GA RN096592) | |
363LF0000X Nurse Practitioner, Family (Licence: WA AP60353041) | |
Enumeration Date | 2010-07-07 |
Last Update Date | 2024-05-29 |