NPI | 1225622855 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA N361156950) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP145417) |
Enumeration Date | 2021-02-24 |
Last Update Date | 2021-10-19 |