NPI | 1235808585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IA A164679) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 1129633) |
207Q00000X Family Medicine (Licence: WI 1129633) | |
363LF0000X Nurse Practitioner, Family (Licence: WI 11296-33) | |
Enumeration Date | 2021-09-09 |
Last Update Date | 2022-07-22 |