NPI | 1609444058 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019822) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC COLE-0167U) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-06-13 |
Last Update Date | 2024-11-07 |