NPI | 1336600964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5011590) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5011590) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NC 5011590) | |
Enumeration Date | 2019-03-27 |
Last Update Date | 2024-07-15 |