NPI | 1124744784 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11022420) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9413666) |
Enumeration Date | 2022-10-17 |
Last Update Date | 2022-12-20 |