NPI | 1073493425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: UT 12379690-3102) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 12379690-4405) |
Enumeration Date | 2025-09-05 |
Last Update Date | 2025-09-05 |