NPI | 1205192689 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 005176) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 005176) |
Enumeration Date | 2012-04-10 |
Last Update Date | 2022-07-11 |