NPI | 1366602146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 22958) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH COA.10058-NP) |
363LF0000X Nurse Practitioner, Family (Licence: NM CNP01610) | |
Enumeration Date | 2008-06-14 |
Last Update Date | 2021-07-06 |