NPI | 1376016048 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11009616) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95009138) |
Enumeration Date | 2019-01-06 |
Last Update Date | 2022-08-19 |