NPI | 1255832754 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 0024184701) |
Additional Taxonomies | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: GA RN236199) |
Enumeration Date | 2018-02-21 |
Last Update Date | 2024-12-11 |