NPI | 1962904581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5010401) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 21713) |
Enumeration Date | 2018-02-28 |
Last Update Date | 2023-07-14 |