NPI | 1629357272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25117) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP011510) |
Enumeration Date | 2011-08-15 |
Last Update Date | 2023-02-23 |