NPI | 1629469846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015001256) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2011002137) |
Enumeration Date | 2015-02-10 |
Last Update Date | 2021-02-18 |