NPI | 1255943775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 288359) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201141583RN) |
Enumeration Date | 2020-08-17 |
Last Update Date | 2023-11-08 |