NPI | 1265073209 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25617) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0995102-NP) |
Enumeration Date | 2019-10-01 |
Last Update Date | 2024-12-12 |