NPI | 1508850892 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013179) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA TP005643C) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP008112) | |
Enumeration Date | 2005-09-01 |
Last Update Date | 2020-07-23 |