NPI | 1689070807 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA 363L00000X) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: ID NP-1515A) |
Enumeration Date | 2014-11-16 |
Last Update Date | 2021-06-02 |