NPI | 1407400559 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004028) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-142605) |
163W00000X Registered Nurse (Licence: FL RN9457625) | |
Enumeration Date | 2019-07-26 |
Last Update Date | 2020-12-07 |