NPI | 1962129916 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11022601) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 0101957) |
363LF0000X Nurse Practitioner, Family (Licence: DE LG0012788) | |
363LF0000X Nurse Practitioner, Family (Licence: NY F354052) | |
Enumeration Date | 2022-10-20 |
Last Update Date | 2024-09-10 |