NPI | 1467129544 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182532) |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
Enumeration Date | 2021-08-25 |
Last Update Date | 2021-08-25 |