NPI | 1164920088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-201519) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 139841) |
Enumeration Date | 2018-01-25 |
Last Update Date | 2024-09-19 |