NPI | 1669916102 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: IA H156626) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95004708) |
363LF0000X Nurse Practitioner, Family (Licence: IA A155258) | |
Enumeration Date | 2016-12-16 |
Last Update Date | 2021-04-06 |