NPI | 1376157180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 225194) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL APRN11008667) |
363LA2200X Nurse Practitioner, Adult Health (Licence: LA 225194) | |
363LF0000X Nurse Practitioner, Family (Licence: FL 11008667) | |
Enumeration Date | 2020-08-31 |
Last Update Date | 2022-09-09 |