NPI | 1336444520 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018024316) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2005031209) |
Enumeration Date | 2011-01-19 |
Last Update Date | 2020-12-13 |