NPI | 1629188818 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95007553) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP128129) |
363L00000X Nurse Practitioner (Licence: IL 209001147) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-02-05 |