NPI | 1023336708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TN 14800) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5014858) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9191490) | |
Enumeration Date | 2010-05-05 |
Last Update Date | 2022-03-25 |