NPI | 1609395102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10028481) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO RN.1638787) |
Enumeration Date | 2017-09-15 |
Last Update Date | 2024-10-24 |