NPI | 1922582170 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9488416) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP60914410) |
Enumeration Date | 2018-09-23 |
Last Update Date | 2023-04-27 |