NPI | 1164984035 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-105083) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-105083) |
Enumeration Date | 2019-04-01 |
Last Update Date | 2021-05-04 |