NPI | 1053956094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-125963) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-125963) |
363LA2100X Nurse Practitioner, Acute Care (Licence: AL 1-125963) | |
Enumeration Date | 2019-11-13 |
Last Update Date | 2023-06-30 |