NPI | 1124662846 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012508) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F09191237) |
Enumeration Date | 2019-11-06 |
Last Update Date | 2025-03-19 |