NPI | 1366176885 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP025144) |
Additional Taxonomies | 261QX0200X Clinic/Center, Oncology (Licence: SP025144) |
261QX0200X Clinic/Center, Oncology (Licence: PA SP025144) | |
Enumeration Date | 2022-07-11 |
Last Update Date | 2022-07-11 |