NPI | 1245776921 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23024RX) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN198256) |
Enumeration Date | 2017-01-18 |
Last Update Date | 2024-11-12 |