NPI | 1710653639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: PA SP028374) |
Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 29989) |
363LF0000X Nurse Practitioner, Family (Licence: TN 29989) | |
Enumeration Date | 2021-08-19 |
Last Update Date | 2024-11-07 |