NPI | 1760092282 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 239278) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 239278) |
363LF0000X Nurse Practitioner, Family (Licence: CO 0995641) | |
Enumeration Date | 2020-08-10 |
Last Update Date | 2025-03-27 |