NPI | 1285150797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 0993305) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 1617869) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2020-05-08 |