NPI | 1265076723 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-164773) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-164773) |
Enumeration Date | 2019-10-29 |
Last Update Date | 2022-09-06 |