NPI | 1336334234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11026042) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 139210) |
363LF0000X Nurse Practitioner, Family (Licence: MO 138210) | |
Enumeration Date | 2007-09-13 |
Last Update Date | 2023-06-07 |