NPI | 1205433794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11033027) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 991233) |
363L00000X Nurse Practitioner (Licence: FL APRN11033027) | |
Enumeration Date | 2020-10-07 |
Last Update Date | 2024-11-15 |