NPI | 1629644463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 220760) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: LA 152434) |
207Q00000X Family Medicine (Licence: LA 152434) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: LA 152434) | |
Enumeration Date | 2021-06-02 |
Last Update Date | 2021-07-26 |