NPI | 1538630900 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 264648) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R220223) |
Enumeration Date | 2018-12-11 |
Last Update Date | 2021-12-08 |