NPI | 1336418425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-100178) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 111333) |
363LP2300X Nurse Practitioner, Primary Care (Licence: IA A-100178) | |
Enumeration Date | 2011-12-20 |
Last Update Date | 2021-06-14 |