NPI | 1316658842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3018746) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209030019) |
363LF0000X Nurse Practitioner, Family (Licence: MI 4704408799) | |
Enumeration Date | 2022-12-06 |
Last Update Date | 2024-10-04 |