NPI | 1164870507 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008575) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008575) |
363L00000X Nurse Practitioner (Licence: NC 5008575) | |
Enumeration Date | 2016-05-26 |
Last Update Date | 2024-07-15 |