NPI | 1356993661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8642674-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60981821) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2022-07-29 |