NPI | 1225618804 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK 204582) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: OK 113764) |
Enumeration Date | 2021-04-08 |
Last Update Date | 2021-09-19 |