NPI | 1629517099 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22241) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174677) |
Enumeration Date | 2017-02-18 |
Last Update Date | 2022-07-21 |