NPI | 1124646682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 27928) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 209274) |
363LP2300X Nurse Practitioner, Primary Care (Licence: TN 27928) | |
Enumeration Date | 2020-07-10 |
Last Update Date | 2024-07-29 |