NPI | 1962959932 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT 104564) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-104564) |
Enumeration Date | 2016-09-07 |
Last Update Date | 2021-09-01 |