NPI | 1770254302 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CO 0101788) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015096) |
363LF0000X Nurse Practitioner, Family (Licence: KY 3017482) | |
Enumeration Date | 2021-09-23 |
Last Update Date | 2025-04-17 |