NPI | 1336494509 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60818381) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 30835.1183) |
363LF0000X Nurse Practitioner, Family (Licence: CO 0990641) | |
Enumeration Date | 2012-07-13 |
Last Update Date | 2021-06-07 |