NPI | 1659845394 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013510) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA Rn28206) |
363LF0000X Nurse Practitioner, Family (Licence: SC 22616) | |
Enumeration Date | 2019-01-16 |
Last Update Date | 2020-09-09 |