NPI | 1194353052 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022309) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CT 63115) |
163WG0000X Registered Nurse, General Practice (Licence: PA RN687908) | |
363LF0000X Nurse Practitioner, Family (Licence: MD R246064) | |
Enumeration Date | 2020-03-27 |
Last Update Date | 2024-05-20 |