NPI | 1194237743 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID NP67517) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 125599) |
Enumeration Date | 2017-11-03 |
Last Update Date | 2021-04-20 |