NPI | 1629553151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61290966) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2319994) |
Enumeration Date | 2018-10-01 |
Last Update Date | 2022-05-24 |