NPI | 1174185367 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A155602) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 103403) |
363LF0000X Nurse Practitioner, Family (Licence: IA F06192819) | |
Enumeration Date | 2019-07-08 |
Last Update Date | 2022-05-25 |