NPI | 1225764277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 173437) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 173437) |
Enumeration Date | 2022-07-30 |
Last Update Date | 2022-09-18 |