NPI | 1194488403 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25755) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-078074) |
Enumeration Date | 2021-10-14 |
Last Update Date | 2024-10-07 |