NPI | 1205594272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025000) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP025000) |
Enumeration Date | 2021-12-07 |
Last Update Date | 2021-12-07 |