NPI | 1770611121 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 10021635) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 564141) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2025-01-30 |