NPI | 1205292455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017962) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R190900) |
363LF0000X Nurse Practitioner, Family (Licence: CA 95003121) | |
Enumeration Date | 2016-01-04 |
Last Update Date | 2024-07-24 |