NPI | 1013642594 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11020941) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9399214) |
Enumeration Date | 2022-07-19 |
Last Update Date | 2025-01-17 |