NPI | 1356749881 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 19424) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VT 101-0135184) |
363LF0000X Nurse Practitioner, Family (Licence: ME CNP191195) | |
Enumeration Date | 2014-12-16 |
Last Update Date | 2022-06-21 |