NPI | 1184396087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 259420) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ 259420) |
Enumeration Date | 2021-09-29 |
Last Update Date | 2025-09-18 |