NPI | 1649624404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10016905) |
Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: MI 4704303950) |
363L00000X Nurse Practitioner (Licence: VA 0024187032) | |
363LF0000X Nurse Practitioner, Family (Licence: SC 25338) | |
Enumeration Date | 2016-04-19 |
Last Update Date | 2024-04-17 |