NPI | 1386125631 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0994114-NP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 40467.1790) |
Enumeration Date | 2018-08-24 |
Last Update Date | 2022-06-08 |