NPI | 1508400169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10028559) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201803203RN) |
Enumeration Date | 2019-11-06 |
Last Update Date | 2024-07-11 |