NPI | 1396264636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 256196) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017143899) |
Enumeration Date | 2017-09-19 |
Last Update Date | 2021-10-30 |