NPI | 1346812880 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021204) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024181639) |
Enumeration Date | 2021-07-14 |
Last Update Date | 2024-11-19 |