NPI | 1417661364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 34020) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MS 916915) |
363LF0000X Nurse Practitioner, Family (Licence: AL 3-001163) | |
Enumeration Date | 2023-01-05 |
Last Update Date | 2023-11-11 |