NPI | 1336734904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 223745) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 648930) |
Enumeration Date | 2021-03-05 |
Last Update Date | 2022-06-01 |