NPI | 1235548363 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902207) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 18863) |
363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02586) | |
Enumeration Date | 2014-08-02 |
Last Update Date | 2022-07-21 |