NPI | 1184343519 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021561) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9496219) |
Enumeration Date | 2022-08-29 |
Last Update Date | 2022-08-29 |