NPI | 1689120271 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11727972-4405) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F341043-1) |
363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP 60650389) | |
Enumeration Date | 2016-09-01 |
Last Update Date | 2021-12-03 |