NPI | 1275194748 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0996780) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 43940) |
Enumeration Date | 2019-06-25 |
Last Update Date | 2023-05-22 |