NPI | 1376052332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21279) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61604177) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11004421) | |
Enumeration Date | 2017-09-21 |
Last Update Date | 2024-10-09 |