NPI | 1639722036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MD R122278) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R122278) |
363L00000X Nurse Practitioner (Licence: DE LP-0000319) | |
363LA2200X Nurse Practitioner, Adult Health (Licence: DE LP-0000319) | |
Enumeration Date | 2019-07-24 |
Last Update Date | 2021-01-22 |