NPI | 1700151362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: AZ 244439) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN172192) |
363LW0102X Nurse Practitioner Women's Health (Licence: NM 56144) | |
Enumeration Date | 2012-03-15 |
Last Update Date | 2020-08-13 |