NPI | 1780072868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV 831710) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28203283A) |
363LF0000X Nurse Practitioner, Family (Licence: IN 28203283A) | |
363LF0000X Nurse Practitioner, Family (Licence: CA 95008353) | |
Enumeration Date | 2014-12-24 |
Last Update Date | 2021-08-06 |