NPI | 1083509418 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1235177031) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL 1194562249) |
Enumeration Date | 2025-06-09 |
Last Update Date | 2025-06-09 |