NPI | 1629563671 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010589) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010589) |
Enumeration Date | 2018-06-22 |
Last Update Date | 2020-10-26 |