NPI | 1578086740 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5232048-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 5232048-4405) |
163W00000X Registered Nurse (Licence: UT 5232048) | |
Enumeration Date | 2017-07-19 |
Last Update Date | 2022-06-01 |