NPI | 1730545534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A163840) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015406) |
Enumeration Date | 2016-01-08 |
Last Update Date | 2021-11-21 |