NPI | 1396522785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11039398) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9623995) |
Enumeration Date | 2023-09-11 |
Last Update Date | 2025-05-28 |