NPI | 1306413174 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP025530) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.0029058) |
Enumeration Date | 2021-06-09 |
Last Update Date | 2023-01-09 |