NPI | 1457043630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 28470A) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024190001) |
Enumeration Date | 2023-05-24 |
Last Update Date | 2024-05-06 |