NPI | 1275050270 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 259934) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R62860) |
363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03361) | |
Enumeration Date | 2017-08-29 |
Last Update Date | 2021-08-30 |