NPI | 1093311342 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 1062933) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1070200) |
363L00000X Nurse Practitioner (Licence: WI 1062933) | |
Enumeration Date | 2020-12-10 |
Last Update Date | 2022-04-06 |