NPI | 1275030801 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-144531) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 144531) |
363LF0000X Nurse Practitioner, Family (Licence: CA 21145) | |
Enumeration Date | 2018-04-10 |
Last Update Date | 2023-09-13 |