NPI | 1619558442 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 61338354) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA 61338354) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95017012) | |
Enumeration Date | 2021-04-14 |
Last Update Date | 2025-01-15 |