NPI | 1265037691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008529) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 11008529) |
Enumeration Date | 2020-12-03 |
Last Update Date | 2023-03-22 |