NPI | 1396350617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: VA 0024179683) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001260561) |
Enumeration Date | 2020-09-14 |
Last Update Date | 2024-03-15 |