NPI | 1164800215 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 237317) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5007938) |
363L00000X Nurse Practitioner (Licence: MD R205065) | |
Enumeration Date | 2015-05-09 |
Last Update Date | 2021-10-21 |