NPI | 1215535935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 9036) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 9036) |
Enumeration Date | 2020-10-14 |
Last Update Date | 2020-11-06 |