NPI | 1376897470 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60315348) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60315348) |
363LF0000X Nurse Practitioner, Family (Licence: CT 10293) | |
Enumeration Date | 2012-10-29 |
Last Update Date | 2022-12-19 |