NPI | 1114623303 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 27212) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017554) |
Enumeration Date | 2023-01-31 |
Last Update Date | 2023-05-11 |