NPI | 1053136853 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP030690) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP030690) |
Enumeration Date | 2024-11-18 |
Last Update Date | 2025-02-18 |