NPI | 1528713328 |
---|---|
Former Name | DESIREE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 32018) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 194301) |
Enumeration Date | 2022-02-21 |
Last Update Date | 2022-10-19 |