NPI | 1770074478 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61591647) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 75755) |
363LP2300X Nurse Practitioner, Primary Care (Licence: MT NUR-APRN-LIC-239199) | |
Enumeration Date | 2018-05-29 |
Last Update Date | 2024-09-27 |