NPI | 1417554338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 255369) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: AZ RN170629) |
Enumeration Date | 2020-10-04 |
Last Update Date | 2021-05-01 |