NPI | 1124154026 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012929) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5012929) |
Enumeration Date | 2007-02-26 |
Last Update Date | 2024-08-20 |