NPI | 1194198234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014538) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA NP95003632) |
363LF0000X Nurse Practitioner, Family (Licence: TN APN0000020435) | |
Enumeration Date | 2015-11-11 |
Last Update Date | 2021-06-16 |