NPI | 1205608619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 12572) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 12572) |
Enumeration Date | 2023-10-30 |
Last Update Date | 2024-07-31 |