NPI | 1588210454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23141) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 23141) |
Enumeration Date | 2019-08-15 |
Last Update Date | 2022-03-02 |