NPI | 1811354251 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 144874) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60593679) |
363LF0000X Nurse Practitioner, Family (Licence: MT 144874) | |
Enumeration Date | 2016-01-15 |
Last Update Date | 2020-11-19 |