NPI | 1245988047 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018437) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9318932) |
164W00000X Licensed Practical Nurse (Licence: FL 11018437) | |
Enumeration Date | 2022-03-11 |
Last Update Date | 2022-03-11 |