NPI | 1568757888 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R187634) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R187634) |
163W00000X Registered Nurse (Licence: CA 847325) | |
363LF0000X Nurse Practitioner, Family (Licence: CT 004705) | |
Enumeration Date | 2011-06-15 |
Last Update Date | 2024-04-11 |