NPI | 1457753378 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25737) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: SC 70358) |
163WD0400X Registered Nurse, Diabetes Educator (Licence: SC 20120385) | |
Enumeration Date | 2014-09-23 |
Last Update Date | 2022-08-24 |