NPI | 1356977557 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 906888) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-174723) |
Enumeration Date | 2020-03-19 |
Last Update Date | 2025-01-15 |