NPI | 1528487097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2017036846) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0991112) |
Enumeration Date | 2014-04-14 |
Last Update Date | 2023-12-13 |