NPI | 1265836373 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: CT 5955) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 5955) |
Enumeration Date | 2014-10-17 |
Last Update Date | 2021-09-13 |