NPI | 1407231590 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10017616) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339376-1) |
363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134159) | |
363LF0000X Nurse Practitioner, Family (Licence: SC 24839) | |
Enumeration Date | 2015-07-30 |
Last Update Date | 2024-02-03 |