NPI | 1811403876 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2303850) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: HI APRN-3475) |
363L00000X Nurse Practitioner (Licence: IL 209.023232) | |
363L00000X Nurse Practitioner (Licence: WA AP61055169) | |
363LP2300X Nurse Practitioner, Primary Care (Licence: NY 345737) | |
Enumeration Date | 2017-12-28 |
Last Update Date | 2022-07-20 |