NPI | 1518639376 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11014909) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: FL 11014909) |
Enumeration Date | 2021-09-30 |
Last Update Date | 2021-10-04 |