NPI | 1619257805 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 247155) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN553834) |
363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 247155) | |
Enumeration Date | 2011-08-19 |
Last Update Date | 2023-03-01 |