NPI | 1316597057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012235) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012235) |
Enumeration Date | 2019-09-15 |
Last Update Date | 2024-07-15 |