NPI | 1124576095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R129320) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MD R129320) |
Enumeration Date | 2016-09-20 |
Last Update Date | 2025-07-28 |