NPI | 1336739812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030520) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9470398) |
Enumeration Date | 2021-01-19 |
Last Update Date | 2024-01-22 |