NPI | 1225564412 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 7024) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 7024) |
363L00000X Nurse Practitioner (Licence: CT 7024) | |
Enumeration Date | 2017-05-07 |
Last Update Date | 2020-02-25 |