NPI | 1487054730 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 65594) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: CO 0991147) |
Enumeration Date | 2014-08-23 |
Last Update Date | 2021-10-25 |