NPI | 1003542648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185380) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: VA 0001235221) |
Enumeration Date | 2022-07-26 |
Last Update Date | 2022-10-26 |