NPI | 1356690549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TN 31800) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95028658) |
363LA2200X Nurse Practitioner Adult Health (Licence: WI 5001-33) | |
Enumeration Date | 2012-09-03 |
Last Update Date | 2024-02-01 |