NPI | 1417339110 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID 72027) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10001014) |
363LF0000X Nurse Practitioner, Family (Licence: NV APRN002049) | |
Enumeration Date | 2015-06-18 |
Last Update Date | 2023-05-31 |