NPI | 1578115903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 5643351-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 5643351-3102) |
Enumeration Date | 2019-07-16 |
Last Update Date | 2020-12-21 |