NPI | 1306485370 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 61033766) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004900) |
Enumeration Date | 2019-12-23 |
Last Update Date | 2020-07-17 |