NPI | 1265769491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R192854) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 75025) |
363LF0000X Nurse Practitioner, Family (Licence: MD R192894) | |
Enumeration Date | 2009-11-09 |
Last Update Date | 2022-08-04 |