NPI | 1336690775 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24756) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 8315356-4405) |
Enumeration Date | 2016-10-20 |
Last Update Date | 2021-08-17 |