NPI | 1215527700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN255745) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RNP253491) |
363LF0000X Nurse Practitioner, Family (Licence: NV 843707) | |
Enumeration Date | 2021-01-19 |
Last Update Date | 2022-07-19 |