NPI | 1679097653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R257088) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP017478) |
Enumeration Date | 2017-08-01 |
Last Update Date | 2024-06-19 |