NPI | 1154943397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 214075) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: LA RN128195) |
Enumeration Date | 2020-05-11 |
Last Update Date | 2023-07-11 |