NPI | 1376031393 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 21783) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 21783) |
Enumeration Date | 2018-04-25 |
Last Update Date | 2023-04-19 |