NPI | 1275143778 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 11977) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ F08200198) |
Enumeration Date | 2020-08-09 |
Last Update Date | 2023-07-20 |