NPI | 1467609784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NURAPRNLIC235271) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-03224) |
363LF0000X Nurse Practitioner, Family (Licence: OH 10100) | |
Enumeration Date | 2008-08-19 |
Last Update Date | 2024-12-11 |