NPI | 1457043630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5022773) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 28470A) |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024190001) | |
Enumeration Date | 2023-05-24 |
Last Update Date | 2025-08-08 |