NPI | 1114508298 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021013570) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-80328) |
Enumeration Date | 2021-04-19 |
Last Update Date | 2024-05-09 |