NPI | 1417645904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A176105) |
Additional Taxonomies | 163WS0121X Registered Nurse, Plastic Surgery (Licence: IA 10977) |
Enumeration Date | 2023-04-24 |
Last Update Date | 2023-09-29 |