NPI | 1407063282 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5003012) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5003012) |
363LF0000X Nurse Practitioner, Family (Licence: SC 3106) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2023-08-04 |