NPI | 1255972253 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23548) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: SC 68634) |
363LP2300X Nurse Practitioner, Primary Care (Licence: SC 23548) | |
Enumeration Date | 2019-10-01 |
Last Update Date | 2022-11-04 |