NPI | 1508136391 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 71013251A) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC 2427) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: WY 058) | |
Enumeration Date | 2012-01-10 |
Last Update Date | 2023-05-23 |