NPI | 1215546429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024179906) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001218994) |
Enumeration Date | 2020-07-24 |
Last Update Date | 2025-06-26 |