NPI | 1790256469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 084620-23) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2290948) |
363LA2100X Nurse Practitioner, Acute Care (Licence: MD R211101) | |
Enumeration Date | 2018-12-06 |
Last Update Date | 2025-06-24 |