NPI | 1780940064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 201910562NP-PP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2005024512) |
363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2012009251) | |
Enumeration Date | 2012-04-11 |
Last Update Date | 2020-03-30 |