NPI | 1164875316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 9658-33) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD AC001844) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024174166) | |
Enumeration Date | 2016-07-22 |
Last Update Date | 2025-07-14 |