NPI | 1013065408 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034464) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9360447) |
164W00000X Licensed Practical Nurse (Licence: MA 67572) | |
Enumeration Date | 2007-01-08 |
Last Update Date | 2024-08-23 |