NPI | 1053193078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD F10230639) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R217372) |
Enumeration Date | 2023-10-16 |
Last Update Date | 2024-02-06 |