NPI | 1265096887 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 60818) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 905324) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP140766) | |
Enumeration Date | 2019-04-29 |
Last Update Date | 2024-04-11 |