NPI | 1790295483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 255601) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010002) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5010002) | |
Enumeration Date | 2017-10-07 |
Last Update Date | 2020-08-27 |