NPI | 1750065462 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F337743-01) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA N361449896) |
363LF0000X Nurse Practitioner, Family (Licence: ID 67722) | |
Enumeration Date | 2023-06-13 |
Last Update Date | 2023-06-13 |