NPI | 1770102329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 202002630NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27371) |
Enumeration Date | 2020-04-14 |
Last Update Date | 2021-08-09 |