NPI | 1760991756 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11006944) |
Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: PA RN-503390-L) |
363LF0000X Nurse Practitioner, Family (Licence: PA SP018031) | |
Enumeration Date | 2017-09-22 |
Last Update Date | 2023-05-31 |