NPI | 1609217348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R50353) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18370) |
363LF0000X Nurse Practitioner, Family (Licence: OH 17405) | |
Enumeration Date | 2013-07-10 |
Last Update Date | 2021-06-15 |