NPI | 1013619857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12764506-4405) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 12764506-3102) |
Enumeration Date | 2023-03-17 |
Last Update Date | 2023-04-18 |