NPI | 1174155683 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012858) |
Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: NC 256650) |
Enumeration Date | 2020-02-12 |
Last Update Date | 2021-11-04 |