NPI | 1407578834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016891) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC NELS-PKSW9) |
Enumeration Date | 2022-09-13 |
Last Update Date | 2022-10-13 |