NPI | 1417528100 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028429) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9448067) |
Enumeration Date | 2021-07-05 |
Last Update Date | 2024-04-23 |