NPI | 1508646852 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11028230) |
Additional Taxonomies | 163WP0000X Registered Nurse, Pain Management (Licence: FL 9548341) |
Enumeration Date | 2023-10-04 |
Last Update Date | 2023-10-04 |