NPI | 1356931042 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 30399) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9492484) |
171000000X Military Health Care Provider (Licence: TN 30399) | |
Enumeration Date | 2021-01-26 |
Last Update Date | 2024-10-14 |