NPI | 1649662925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014693) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SPO14693) |
Enumeration Date | 2015-02-24 |
Last Update Date | 2021-12-29 |