NPI | 1801308242 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5019590) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5019590) |
363LF0000X Nurse Practitioner, Family (Licence: SC 21252) | |
Enumeration Date | 2017-10-25 |
Last Update Date | 2024-08-07 |