NPI | 1508518101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC FARO-XAYDS) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 321603) |
Enumeration Date | 2022-01-25 |
Last Update Date | 2022-01-25 |