NPI | 1255973970 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-169840) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-169840) |
363LP2300X Nurse Practitioner, Primary Care (Licence: AL 1-169840) | |
Enumeration Date | 2019-10-14 |
Last Update Date | 2023-06-29 |