NPI | 1457004624 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015743) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC F01220988) |
Enumeration Date | 2022-01-28 |
Last Update Date | 2023-02-22 |