NPI | 1871046383 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017526) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20221) |
363LF0000X Nurse Practitioner, Family (Licence: CT 9417) | |
Enumeration Date | 2016-08-01 |
Last Update Date | 2024-07-31 |