NPI | 1730456005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP022179) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 651536) |
363LF0000X Nurse Practitioner, Family (Licence: NY 337056) | |
Enumeration Date | 2011-11-30 |
Last Update Date | 2021-02-01 |