NPI | 1295460459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 012532) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN296591) |
Enumeration Date | 2022-07-21 |
Last Update Date | 2023-12-12 |