NPI | 1255476677 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 5905) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 64614) |
363L00000X Nurse Practitioner (Licence: AR A005747) | |
Enumeration Date | 2007-02-21 |
Last Update Date | 2021-07-19 |