NPI | 1578120135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 112913) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NE 76205) |
363L00000X Nurse Practitioner (Licence: IA A161766) | |
Enumeration Date | 2019-05-20 |
Last Update Date | 2021-02-02 |