NPI | 1639576994 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6123) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95001912) |
363LF0000X Nurse Practitioner, Family (Licence: CO C-RXN.0000486-C-NP) | |
363LF0000X Nurse Practitioner, Family (Licence: ND R46409) | |
363LF0000X Nurse Practitioner, Family (Licence: IA A151649) | |
363LF0000X Nurse Practitioner, Family (Licence: MN 5849) | |
Enumeration Date | 2014-12-01 |
Last Update Date | 2018-09-14 |