NPI | 1417311630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901359) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 901359) |
Enumeration Date | 2016-04-13 |
Last Update Date | 2021-06-15 |