NPI | 1376099424 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R39903) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-104610) |
363LA2200X Nurse Practitioner, Adult Health (Licence: ND R39903) | |
363LF0000X Nurse Practitioner, Family (Licence: MT 104610) | |
Enumeration Date | 2016-08-29 |
Last Update Date | 2019-08-05 |