NPI | 1316619091 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 221505) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 221505) |
Enumeration Date | 2021-10-01 |
Last Update Date | 2024-10-02 |