NPI | 1134609209 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 22077) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22077) |
Enumeration Date | 2018-08-18 |
Last Update Date | 2022-06-01 |