NPI | 1275134207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016306) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009847) |
Enumeration Date | 2020-11-05 |
Last Update Date | 2022-06-20 |