NPI | 1013611425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 33931) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024185836) |
Enumeration Date | 2023-03-29 |
Last Update Date | 2023-05-08 |