NPI | 1417569732 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WY 46184) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 46184) |
Enumeration Date | 2020-08-18 |
Last Update Date | 2023-09-14 |