NPI | 1790027357 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2013009204) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95004121) |
363LF0000X Nurse Practitioner, Family (Licence: PA sp016093) | |
363LF0000X Nurse Practitioner, Family (Licence: KS 53-76627) | |
Enumeration Date | 2013-03-21 |
Last Update Date | 2019-10-25 |