NPI | 1922623255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5014735) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5014735) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: SC 39208) | |
Enumeration Date | 2020-06-12 |
Last Update Date | 2022-07-01 |