NPI | 1417506908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11004409) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9367470) |
Enumeration Date | 2019-09-06 |
Last Update Date | 2021-05-26 |