NPI | 1407020589 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5004259) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 3535) |
363L00000X Nurse Practitioner (Licence: NC 5004259) | |
363LF0000X Nurse Practitioner, Family (Licence: SC F3535) | |
Enumeration Date | 2008-04-18 |
Last Update Date | 2023-06-22 |