NPI | 1326514316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5016871) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024176350) |
Enumeration Date | 2018-10-17 |
Last Update Date | 2024-08-07 |