NPI | 1043647340 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R124929) |
Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: MD R124929) |
261Q00000X Clinic/Center | |
363LF0000X Nurse Practitioner, Family (Licence: DC RN58440) | |
Enumeration Date | 2013-10-01 |
Last Update Date | 2025-05-12 |