NPI | 1649684267 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 28611) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171515) |
Enumeration Date | 2014-06-12 |
Last Update Date | 2024-05-29 |