NPI | 1780109868 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60796718) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA RN60796717) |
363LF0000X Nurse Practitioner Family (Licence: MI 4704205199) | |
Enumeration Date | 2017-08-09 |
Last Update Date | 2021-03-22 |