NPI | 1164641908 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN3204RX) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 201524) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2024-07-24 |