NPI | 1669124814 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 297292) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020011332) |
Enumeration Date | 2022-01-19 |
Last Update Date | 2024-03-01 |