NPI | 1336511575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 6091135) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN219260) |
363LF0000X Nurse Practitioner, Family (Licence: GA 219260) | |
Enumeration Date | 2015-10-27 |
Last Update Date | 2018-12-26 |