NPI | 1659724946 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2016028753) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 105320) |
Enumeration Date | 2016-07-21 |
Last Update Date | 2025-09-18 |