NPI | 1609572221 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5899567-4405) |
Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: UT 5899567-3102) |
363LP2300X Nurse Practitioner, Primary Care (Licence: UT 5899567-4405) | |
Enumeration Date | 2023-02-06 |
Last Update Date | 2023-08-10 |