NPI | 1336570514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 8083) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 5619-33) |
163W00000X Registered Nurse (Licence: WI 160820-30) | |
Enumeration Date | 2013-12-12 |
Last Update Date | 2019-04-25 |