NPI | 1689044018 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21394) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008021) |
Enumeration Date | 2015-09-28 |
Last Update Date | 2021-05-14 |