NPI | 1720455660 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 312886) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201506113NPPP) |
Enumeration Date | 2015-08-26 |
Last Update Date | 2024-10-29 |