NPI | 1124759337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030207) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9585457) |
Enumeration Date | 2022-06-20 |
Last Update Date | 2023-12-17 |