NPI | 1629685599 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904388) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
163W00000X Registered Nurse (Licence: MS 902568) | |
Enumeration Date | 2020-09-25 |
Last Update Date | 2021-11-04 |