NPI | 1376125617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29224) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3016049) |
Enumeration Date | 2021-04-26 |
Last Update Date | 2021-10-18 |