NPI | 1528533700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 174525) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134215) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2024-02-20 |