NPI | 1013644962 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5020058) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9382877) |
363LF0000X Nurse Practitioner, Family (Licence: FL 11021254) | |
Enumeration Date | 2022-08-02 |
Last Update Date | 2024-08-06 |