NPI | 1376215632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25467) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9470945) |
Enumeration Date | 2021-10-04 |
Last Update Date | 2024-12-03 |