NPI | 1104568997 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NV 850287) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 789473) |
363LF0000X Nurse Practitioner, Family (Licence: WA AP61339903) | |
Enumeration Date | 2022-04-11 |
Last Update Date | 2023-04-24 |