NPI | 1316592629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 112980) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE F05190873) |
363LF0000X Nurse Practitioner, Family (Licence: HI F05190873) | |
Enumeration Date | 2019-08-04 |
Last Update Date | 2019-10-12 |