NPI | 1295374742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23472) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021107) |
363LF0000X Nurse Practitioner, Family (Licence: FL TPAN2691) | |
Enumeration Date | 2020-01-02 |
Last Update Date | 2025-01-23 |