NPI | 1336676444 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015083) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007509A) |
Enumeration Date | 2017-05-19 |
Last Update Date | 2022-03-18 |