NPI | 1801355466 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN 25511) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN284659) |
363LF0000X Nurse Practitioner, Family (Licence: TN 25511) | |
Enumeration Date | 2019-03-13 |
Last Update Date | 2019-12-10 |