NPI | 1487377347 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11036988) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2022021665) |
Enumeration Date | 2022-09-26 |
Last Update Date | 2025-06-11 |