NPI | 1902379142 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP022379) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00883900) |
Enumeration Date | 2019-01-10 |
Last Update Date | 2022-03-07 |