NPI | 1508379504 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP10601) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN166497) |
Enumeration Date | 2017-11-13 |
Last Update Date | 2020-09-09 |