NPI | 1508359043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018029917) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2009005945) |
Enumeration Date | 2018-06-09 |
Last Update Date | 2024-08-06 |