NPI | 1487350369 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024910) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1017168) |
Enumeration Date | 2023-02-02 |
Last Update Date | 2024-01-22 |