NPI | 1104488626 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187638) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 26026) |
Enumeration Date | 2019-07-04 |
Last Update Date | 2023-07-27 |