NPI | 1164932026 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 082756-23) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL 1108849) |
Enumeration Date | 2017-10-05 |
Last Update Date | 2020-06-09 |